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Objective To investigate the expression of Akt and phosphoryled Akt (p-Akt1) protein in pancreatic carcinoma and to determine the clinical significance. Methods In 74 cases of pancreatic carcinoma and 10 cases of normal pancreatic tissue samples, the expression of Akt and p-Akt1 were detected by immunohistochemical method, and the its relationship with clinicopathologic characteristics and prognosis were analyzed. Results The positive expression rate of Akt and p-Akt1 in pancreatic carcinoma were 87.8% and 83.8% respectively, while there was no expression of Akt and p-Akt1 in normal pancreatic tissue, and the difference was statistically significant (p < 0.05). There was a positive correlation between the expression of Akt and p-Akt1 in pancreatic carcinoma (r =0.274, P =0. 018). The expression of Akt and p-Akt1 was not significantly associated with the age, sex, location, size, pathology stages, lymph nodes metastasis, clinical stages and nerve invasion of the tumor (P >0.05). But the higher expression of p-Akt1 was associated with T stages and TNM staging (p =0. 002). Patients with high intensity of Akt and p-Akt1 expression showed a significantly longer median survival time [(16.0 ± 5.7) month and (23.0 ± 5.5) month, respectively]than those with low intensity expression [(9.3 ± 0.2) month and (11.1 ± 1.8) month (P = 0. 007 and P = 0.004) respectively]. Conclusions p-Akt1 expression is a significant positive prognostic factor for pancreaticcarcinoma and detection of p-Akt1 expression may be of clinical value.
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Objectives:To investigate the effect of glutamine on the shape of residual intestine and colon in rats with short bowel syndrome. Methods:23 male Sprague-Dawley rats,underwent a 80% small bowel resection,were randomly divided into three groups:food group(n=8) rats,fed rat chow and water libitum after operation;TPN group(n=8),infused with Gln-supplied TPN;and normal control group.On seventh day after operation,rats were weighted and remaining jejunum、remaining ileum and colon were harvested for histological observation(light microscopy and electron microscopy). Results:There was significant difference in rat average weight between food group and Gln group after operation.Jejunal mucosal villus height(VH) and mucosal thickness(MT) and ileal mucosal VH in food group were significantly increased than those in control group.Jejunal mucosal VH and MT in control group were significantly higher than in TPN group.Ileal mucosal crypt depth(CD) and MT in control group were also significantly higher than in TPN group.Jejunal and ileal mucosal VH、CD and MT in Gln group were significantly higher than in TPN group.Colonic MT in food group was significantly higher than in control group.Colonic MT in Gln group was significantly bigger than in TPN group. Conclusions:After 80% intestinal resection,the remaining intestine can develop the adaptation,but the adaptation is incomplete.TPN therapy can maintain body weight,but only TPN can not result in the adaption.Gln-supplied TPN can stop the remaining itestinal mucosal atrophy,and promote the remaining intestinal adaptation and colonic mucosal hypertrophy.
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Objectives:To investigate the effects of intravenous LCT or MCT/LCT fat emulsions on the lipid mediators and pancreatic histological changes in ANP rats. Methods:Forty three male SD rats were randomized to groups as follow.Group A～C were without ANP, group A:normal controls, group B:normal rats having received lipid based TPN and group C:operation control(OC) group having received the glucose fluid.Group D～F were with ANP,glucose group,Intralipid group and Lipofundin group.The amylase and prostaglandins in serum were determined in group A.Pancreatic histological examinations were also performed.In group B～F,Amylases or prostaglandins in serum were determined at 4,48 and 72 h, and pancreatic histological examination and pathological scoring were also completed. Results:Intralipid had no effects on serum prostaglandins when it was infused to normal rats.In groups of ANP,intravenous fat emulsion increased the 6 keto PGF 1? ,and PGE 2 concentration in serum at 4 h.Pancreatic hemorrhagic and fat necrosis were significantly reduced in Lipofundin group. Conclusions:Intravenous fat emulsion does not worsen the damages to pancreas in ANP.MCT/LCT fat emulsion is more suitable for patients with ANP.
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Objectives:To investigate if enteral nutrition can reduce pancreatic infection of severe acute pancreatitis(SAP) in rats. Methods:32 SD rats were divided into 4 groups.SAP was induced in rats of A group and C group, and rats fo B group and D group underwent laparotomy without induction of SAP. A group and B group received total parenteral nutrition(TPN),and C group and D group received enteral nutrition(EN) beginning from the 3rd postoperative day.The samples of blood,MLN,pancreas,liver,kidney and lung were detected for bacteria at the end of the study.Blood sugar,albumin and amylase were also detected. Results:None of the rats died.The positive rates of bacteria cultures in MLN and pancreas were significantly lower in C group(37.5%) than those in A group(87.5%)( P =0.033).The species of cultured bacteria were mainly those seen in the gut. Conclusions:Enteral nutrition can reduce the pancreatic infection of severe acute pancreatitis in rats.
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Objective:To evaluate the effects of perioperative glutamine-supplemented total parenteral nutrition support on nutritional status of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer were randomized into three groups.The group of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric(104.6 kJ/(kg?d) and isonitrogenous(0.20 g/kg?d~(-1)) total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting for 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.Nutritional status was determined by body weight,triceps skinfold thickness,arm muscle circumference,plasma concentrations of albumin,prealbumin transferin,glutamine,muscle concentration of glutamine and nitrogen balance.Results:No serious complications occurred in any groups during the trial.Body weight,triceps skinfold thickness,arm muscle circumference,plasma concentrations of prealbumin,transferin and nitrogen balance were not significantly different among groups.On postoperative day 6,the concentration of glutamine in blood and muscle in Gln-TPN group was higher than that in other two groups.Conclusions:Glutamine-supplemented TPN is beneficial to alleviating the state of catabolism caused by chemotherapy and operation.It can raise the concentrations of glutamine in blood and muscle,decrease the loss of muscle and fat tissue and promote synthesis of protein.
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Objective:To evaluate the perioperative effects of glutamine-supplemented total parenteral nutrition support on immune function of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer randomized into three groups.The groups of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric 104.6 kJ/(kg?d) and isonitrogenous 0.20 g/(kg?d)total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.All variables were measured before and after operaition.Immune function and inflammatory responses were investigated.Results:No serious complication occurred in any group during the trial.The percentages of CD3~(+)cell and CD8~(+) cell decreased in three groups after operation.The percentage of CD4~(+)cell and NK cell and the ratio of CD4~(+)/CD8~(+) of group B was the highest in the three group on the sixth day after operation.Total lymphocyte count was higher in group B than that in group A and the levels of C reactive protein and prostaglandin E_(2) in group B were lower than those in group A.Conclusions:Glutamine-supplemented TPN is beneficial in raising total lymphocyte count and decreasing the level of C reactive protein and prostaglandin E_(2).And it can also modulate immunosuppressive status and inflammatory response of postoperative patients.